Military families’ health care delayed: study

Tamara Kleinschmidt, the Trenton Military Family Resources Centre's executive director, speaks to Hastings County council in Belleville, Ont. Thursday, Aug. 27, 2015. She said a new study released Oct. 5, 2018 on delays experienced by military families seeking health care helps organizations to focus their efforts on solutions. Luke Hendry/Belleville Intelligencer/Postmedia Network
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Tamara Kleinschmidt, the Trenton Military Family Resources Centre's executive director, speaks to Hastings County council in Belleville in 2015. She said a study released Oct. 5, 2018 on delays experienced by military families seeking health care helps organizations to focus their efforts on solutions. Luke Hendry/Belleville Intelligencer/Postmedia NetworkLuke Hendry / Luke Hendry/The Intelligencer

Military families have more difficulty and delays in finding family doctors and specialists than do other Canadians, a new study reveals. The findings were published Friday in the journal Military, Veteran and Family Health Research. The study’s entitled, “Access to healthcare and medical health services use for Canadian military families posted to Ontario: a retrospective cohort study.” “This is the first Canadian study to examine healthcare services use for the spouses and dependents of active Canadian Armed Forces members,” lead researcher Dr. Alyson Mahar said in a press release. She and her colleagues of the Toronto-based Institute for Clinical Evaluative Sciences (ICES) conducted the study over the course of a year. Those serving in the military receive continuous care through the federal defence health care system, but their families have a much more frustrating experience, the researchers found. “Any time you move across a provincial border you’re restarting your health care journey,” Mahar said from Winnipeg. The study was limited to physical – not mental – health. Researchers learned 18 per cent of military families first received care in Ontario in a hospital emergency department compared to 14.7 per cent of civilian families. They waited longer for their first contact with the health system: 118 days versus civilians’ 83 days. Military families also waited nearly a year to see medical specialists – almost three months longer than the average civilian wait of 247 days. “We’re trying to start conversations with provincial governments around, specifically, these wait times,” Mahar said, “so that families are not disadvantaged because of their occupation.” She said Canadian military families move three to four times more often than civilians. It means finding new doctors and re-establishing care, even when in the midst of treatment or waiting for a referral, she said. More than 57,000 military families are eligible for care from civilian health care providers in provincial and territorial health systems. Of those, 40 per cent live in Ontario. Mahar said the study was motivated by reports a 2013 report by the Department of National Defence ombudsman. It cited concerns about families’ ability to access care. But there was “a lack of Canadian data that could help support policy change,” said Mahar, who said she’s interested in healthy equity and had been researching veterans’ care. The study’s researchers used the institute’s existing data on military families in Ontario. They did not work directly with families. Mahar said the study was intended solely as a starting point to assess the situation and hopefully help providers to find solutions. “We’re not able to understand the why or the how. “There are sometimes more questions than answers when a study like this is completed.” Children of people in the military were found to be less likely to see a pediatrician than other Canadian children, Mahar said. Again, it’s not clear why: Mahar said military families may be healthier because their parents’ private medical plans could allow better access to private services. But there’s no evidence of that, she noted, and it’s also possible civilian and military families’ health are roughly the same. Staff of the Trenton Military Family Resource Centre participated in the study. The MFRC’s executive director, Tamara Kleinschmidt, welcomed the research team’s work, saying health care is the top concern among the centre’s clients. “It has the biggest impact … the biggest consequences,” on their lives, she said. She also said the findings confirm what she and her staff already know, some of them first-hand. “All of our families struggle the moment they’re posted into Trenton,” said Kleinschmidt. “Family doctors are a rarity and (their practices are) often full.” Her husband retired recently from the military. Kleinschmidt they were posted to Trenton three times in 20 years. “We didn’t have a family doctor until well through the last posting. “I’m always impressed with the amount of work that’s being done to research military and veteran families in Canada,” Kleinschmidt said. “It’s so helpful, because now we know where to focus our efforts.” Prior to such research, she said, “we were basically dealing with American research,” which didn’t reflect Canadian values and views. Kleinschmidt said there “has been some progress” in addressing delays in care for military families. In Ontario, for example, there’s no longer a three-month wait to receive a provincial health benefits card. She added the military has also been working with the provinces. “It’s certainly a high priority for everybody involved.” Mahar said it’s “critical” that many organizations and health care providers work together in finding answers and solutions. Several already are. “I would encourage more research being done in academic institutions to support military family health and wellbeing and also greater engagement with military families themselves to ensure we’re asking the right questions when we do research,” she said. Researchers should also ensure their findings can be used “for helpful solutions,” Mahar added. She said further research is underway. “This is an Ontario snapshot only,” she said, but the team recognizes the situation may be worse in provinces with greater shortages of doctors. Mahar led the study while a post-doctoral trainee with ICES. She’s now an assistant professor at the University of Manitoba and a research scientist with the Manitoba Centre for Health Policy. She said the team is now trying to gather similar data in Manitoba and studying geographic differences in access to or use of health care. “We’re doing a separate look with Canadians Forces Morale and Welfare Services looking at mental health services use” among military spouses and children, Mahar added. The study was funded in part by the Queen’s University Research Initiation Fund and by ICES, which receives an annual grant from Ontario’s health ministry. lhendry@postmedia.com